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Of course in some people's ideal world every intervention in the biological and social spheres would be evaluated with a randomised controlled trial. But the world is not such a utopia. As a consequence there are important roles for observational methods used with the care and rigour that, hopefully, trialists bring to their studies. What are those roles?
Firstly, some interventions, such as defibrillation for ventricular fibrillation, have an impact so large that observational data are sufficient to show it.
Secondly, infrequent adverse outcomes would be detected only by randomised controlled trials so large that they are rarely
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